The aim of this book is to give an overview on the state of the art, the actuality and the future perspectives of the diagnosis and treatment of lumbar spinal pathologies, highlighting the fundamental role of multidisciplinary management. In this field, neurosurgeons and orthopedics function two different ways; in fact, there are some spine pathologies that are actually described exclusively for orthopedics, such as congenital and developed scoliosis, while others are specifically for neurosurgeons, such as intra-extradural pathologies. In light of this, it may be extremely useful to report neurosurgical and orthopedic experience in the field of lumbar spine. Moreover, the contribution of other specialists, such as infectivologists, cardiologists, and neuroradiologists should be mentioned. This book is written by a group of highly trained, multidisciplinary specialists from all over the world, who present the requirements for the most advanced therapies on the aged, adult and pediatric thoracolumbar spine. The chapters report the diagnostic and therapeutic management of the thoracolumbar pathology while presenting a step by step presentation of the most advanced procedures. New technologies such as spinal neuronavigation, transfacet fixation devices and minimally invasive techniques are extensively described. Considering the growing incidence of spinal disease, the authors aim to provide an expert overview of lumbar spine treatment to assist the medical community with treating this increasingly common pathology. This book aims to provide a message: Surgery must not become a trend, but a weapon in the surgeon’s hands; and as with every weapon, it is extremely dangerous in the wrong hands. The spinal surgeon is the only one who can decide when to use it and must know in detail the effects of this weapon to use it correctly.